Longing

Towards the end of the week, Woodson, our ex-preterm baby caught his first cold. He was struggling to breathe had to be started on oxygen. We watched Woodson very, very carefully. I am pleased to be able to report that he is doing better today, and only needs a tiny amount of supplemental oxygen, through a nasal cannula, when he falls asleep. If he continues to improve, we will discharge Woodson home at the end of the week. He was due to be born this week. It is very rewarding to be able to send him home as a chubby, thriving 'newborn.'

On Monday, I placed our new little girl, Naila, into Miss Vicky's care. Naila was referred to us by an orphanage in Kenscoff, who were struggling to recover her from her malnutrition. We don't know how old Naila is but we suspect that she might be close to 2 years old. She weighed almost 13lb the day that she arrived. She was very dehydrated and refused to eat or drink. We are told that she was abandoned. No one could tell us her history, but it was clear, from her sorrowful expression and empty stare, that this toddler was in deep mourning.
Miss Vicky is a retired nurse-volunteer, who specializes in providing short-term foster care to children who fail to grow and thrive, not because they don't have enough food to eat, but because they have been abused or neglected. I am all ready seeing signs of improvement in Naila. She is opening up, and beginning to give us eye contact, smile, babble, and play. Naila is a wounded spirit, in a frail body. A spiritual healing will in all likelihood, lead to improvements in her appetite and general health. Miss Vicky is a wise and loving foster mother, and we both agree that patience and kindness, rather than force, will be crucial to Naila's healing.

Gorgeous, and bright-eyed, this 5 month old baby arrived a few hours before Naila did. Hansley weighed 8 lb when he was admitted. Like Naila, he has been placed with us for short-term care, so that he can recover from his malnutrition. Hansley's mother is dead and his young Father left the orphanage with tears coursing down his face. There is something profoundly hurtful about that Daddy's tears, about him loving his baby so, so much, being unable to provide for him, forced to surrender him. I watched Hansley's father from the NICU balcony. His eyes rose up to meet mine. His cheeks glistened with dampness, and then, with bowed head and lowered eyes, he stepped through the gate, which was closed behind him.

Angela was referred to us from another orphanage in the Thomassin area. Angela is 8 months old and she weighs 12 pounds. She comes from an area in the plains beyond Port-au-Prince, and she has been sick with gastroenteritis for some time. Angela had a parasite in her gut that caused severe diarrhoea. By the time the staff from her orphanage arrived here with her, she was severely dehydrated and needed IV fluids.

A line was sited in her foot. I left Angela in the care of the night nurse and returned in the morning, to find the baby's leg swollen up past the knee. The Iv had perforated the vein and the infusion fluid had seeped under her skin. Angels's leg was grossly swollen, hard to touch, shiny and seeping fluid. A few hours later,  the skin on her foot split open due to the pressure of the fluid that had built-up. I was so upset. It is a nursing responsibility to observe IV sites every hour and to remove the lines if there are any signs of redness, swelling, infection or hardening of the vein. Our night nurse had clearly left the child and the teenaged care-giver, who, had accompanied her from her orphanage, alone in a room overnight.

Now, Angela has a serious wound on her foot. The pressure of the fluid compromised blood flow to the skin and the tissues below it. As a result,  these tissues have died and infection has set in. Angela has lost so much tissue on the back of her foot that the surgeon we took her to says that she will need a skin graft. Unfortunately, this baby is too anaemic, to frail and too weak for surgery. We are doing our best to get her weight up and get her strong.

It is my prayer that she will experience a miraculous healing, and that she will not need surgery at all. I feel a heavy weight of responsibility: a child in need has come to us for help. As a result of negligent care, she has sustained a serious and preventable injury. I cannot be in the nurseries 24 hours a day, yet still, yet I am accountable for the nursing care that is delivered in the nurseries around the clock. I am frustrated, because although I strongly feel that the nurse who was on duty that night should be called to account for allowing this injury to occur, and that steps should be taken to ensure this incident is not repeated, it has been decided that the orphanage will pay for the baby's surgical care, but that the nurse is not to be called to be challenged. It has also been decided that no changes are to be made to the way that the staff account for the care that they provide. Although I lead the nursing staff and the nannies, and have a great deal of decision making authority in terms of the care and treatment that the babies receive, I have virtually no authority to change the systems and ways of working that are in place. As a result, some poor practices persist. The excuse that these aspects of care are cultural is wearing thin. I want the best for these babies, the very best I can give, and I sense God calling me to continuously push boundaries, to make things better.

I feel privileged to be able to tend to 'the least of these.' I know that I can speak for all of the staff, Haitian and foreign, when I say that we long for the day when our home will fill up again, with children who need the care and the healing that we can provide.